2026 Autism Support Program

2026 Autism Support Program - Application
This is the application to apply for Autism Everyone's Autism Support Program Application for 2026. Please read the terms and conditions located on the next page and fill out the remaining application. Applications will not be accepted if they are not submitted by the closing date below.

Note: Contact your chosen service provider IN ADVANCE to make sure the individual's needs can be accommodated.

Families will not be awarded if they have not contacted the provider. Families who are awarded will be notified by March 16th, 2026. Thank you!

SUPPORT PROGRAM OPENS ON: February 1st, 2026

SUPPORT PROGRAM CLOSES ON: February 27th, 2026

SUPPORT PROGRAM AWARDED ON: March 16th, 2026

Program Policy
- The purpose of the autism support program is to provide a lump-sum amount to selected (awarded) recipients to assist with paying for autism-related products or services.
  
  The program is designed to provide a financial award paid to the provider of autism-related products or services identified by the award recipient.
- - Autism Everyone will promote this program through the Autism Everyone website, Facebook page, and via email when possible.
  - Applicants shall complete in full an Autism Everyone Autism Support Program application and shall agree to the terms and conditions of this policy.
  - The signed policy and completed application shall be postmarked by the date previously mentioned. Applicants may either: - send their completed applications via US Mail (to Autism Everyone, 3700 Bellemeade Avenue, Suite 116 Evansville, IN 47714),
    -email their application to: kelsey@autismeveryone.org
    -or turn in completed applications to their selected service provider, who will submit the application to Autism Everyone.
    There will be no exceptions for late applications, or for incomplete applications. Any applications received by Autism Everyone after the deadline, whether by mail or from a service provider, will not be considered.
  - The awarded recipient(s) will be notified by the Executive Director that they have been selected to receive the program award. Applicants who did not receive the award will not be contacted.
  - Program awards shall be awarded to the selected recipient. They shall be paid directly to their provider of choice (on behalf of the recipient) to receive products or services from the provider.
  - Once a recipient has received a program award, he/she is unable to reapply for another voucher award for 12 months from the date of the award.
  - A recipient is required to utilize the funds awarded to the provider within 12 months of receiving the award. Any unused funds remaining after the 12 months have passed shall be forfeited.
  - Providers must agree to the terms and conditions of receiving and applying program award funds. Autism Everyone may request the return of unused funds from the provider at the end of 12 months. Providers and recipients are required to sign a Provider Agreement form before the commencement of services and payment.
  - There can be no program award payment for a service or product that has been received or purchased prior to the date that the program award was awarded, or the date that the Autism Support Program Provider Agreement form has been signed by the provider and recipient.
  - If the program award is for the purchase of a product, the cost of the product must be equal to or less than the amount of the program award, including tax and shipping costs.
  - Program award recipients will be requested to complete Autism Everyone survey questions and follow-up inquiries about the program.
  - If a recipient is released from the service for which the program award was awarded before the full amount of the award has been spent, or voluntarily leaves the chosen provider of services, there can be no transfer of the remaining award amount to another family, individual, provider of services, or to the same provider for a different service.
  - If a recipient is released from the service for which the program award was awarded before any part of the voucher has been spent, there can be no transfer of the full or partial award amount to another family, individual, provider of services, or to the same provider for a different service. In this case, only the recipient will be eligible to reapply for the support program the next time it is offered.
- - All completed applications will be reviewed by the Executive Director. The Executive Director will complete a summary of each application so that all identifying information is concealed. Each application summary will be assigned an identification number.
  - The Selection Committee will review the application summaries to determine the Autism Everyone award(s) for that selection period.
  - Members of the Autism Everyone Board (and their households) shall be excluded from eligibility of the Autism Everyone Autism Support Program.
  - To be eligible for consideration, the applicant must meet eligibility requirements (the individual for whom the program award is intended as a legal dependent age 21 or under with an autism diagnosis, and he or she lives within the states Autism Everyone serves and the applicant completes in full an Autism Everyone Autism Support Program application, including this signed policy).
  - Preference may be given to situations where the individual is not waitlisted for the requested services.
  - Thereafter, the Criterion used for consideration will include, but not be limited to:
    a. The description of the needs identified by the recipient
    b. The proposed products/services identified by the recipient
    c. The cost of the products/services that will be received
    d. The financial hardship of the recipient
  Autism Everyone makes no representations, warranties, or opinions regarding the effectiveness or appropriateness of services or products funded on a designated award recipient's behalf via Autism Everyone's Autism Support Program. Payment of voucher awards to service or product providers (hereinafter collectively referred to as "providers") on a designated recipient's behalf is contingent upon the provider's ability to coordinate payments in conformity with Autism Everyone's Autism Support Program procedures as determined by Autism Everyone in its sole authority and discretion. Autism Everyone reserves the right to revoke its award to a designated award recipient at any time prior to the actual payment of the award to a provider, and the designation of an award recipient does not guarantee that Autism Everyone will be able to coordinate payment with the recipient's identified provider. In the event that payment cannot be coordinated with a designated recipient's identified provider, Autism Everyone may in its sole authority and discretion revoke the voucher award, or Autism Everyone may request the designated award recipient identify an alternative provider. Any voucher award that has not started payment to a provider on behalf of a designated recipient within 60 days of the recipient's designation date is subject to revocation by Autism Everyone in its sole authority and discretion.

Recipient Information
Child's Name:*

First NameLast Name
Child's DOB:*

MonthDayYear
Date
Child's Gender:*

MaleFemale
Today's Date:

MonthDayYear
Date
Child's Age:*

Parent/Guardian Information
Parent/Guardian Name:*

First NameLast Name
E-mail Address:*
example@example.com
Primary Phone Number:*
Please enter a valid phone number.
Secondary Phone Number:
( if applicable )
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Application Submission
TOTAL VALUE
By signing this form, the applicant represents that all information provided is truthful and accurate. The applicant certifies that the individual specified has received a diagnosis of an autism spectrum disorder from a qualified professional. The applicant also recognizes AE reserves the right to request verification of any information on the application. Furthermore, the applicant acknowledges that they have read and understand the Autism Everyone Autism Support Program Guidelines and agrees to comply with all requirements of this program. The applicant holds no liability to Autism Everyone or its members for this program or the quality of provider services received.

If there are any changes to this application after you have submitted it, please contact our Executive Director, Kelsey Schapker, at kelsey@autismeveryone.org. Thank you!
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2026 Autism Support Program - Application

Program Policy

Recipient Information

Parent/Guardian Information

Additional Information (1 of 2)

Additional Information (2 of 2)

Application Submission